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Non-Hodgkin LymphomaPhase 2NCT00444912

The Effect of Rituximab on Mobilization With AMD3100 (Plerixafor) Plus G-CSF in Patients With Relapsed or Refractory Non-Hodgkin Lymphoma (NHL) or Hodgkin Disease (HD)

A Phase 2 study testing G-CSF plus plerixafor and rituximab in people with Non-Hodgkin Lymphoma and Hodgkin Disease, run by Genzyme, a Sanofi Company at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Participants with non-Hodgkin lymphoma (NHL) or Hodgkin disease (HD) will be assigned to one of 2 arms based on the immunophenotype of their lymphoma. (A)Participants with CD20(-) lymphoma will undergo mobilization with granulocyte colony-stimulating factor (G-CSF) and plerixafor. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Non-Hodgkin Lymphoma, Hodgkin Disease
What is being tested?
G-CSF plus plerixafor and rituximab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteUnited States
Study dates
Feb 2006to Jun 2009
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histological diagnosis of diffuse large cell lymphoma, B-cell, T-cell or anaplastic histologies; peripheral T-cell lymphoma; small non-cleaved Burkitt-like lymphoma; or Hodgkin disease. NOTE: Participants diagnosed at a facility outside of Emory University will have their diagnosis confirmed by Emory University pathologists prior to being enrolled in this study.
  • Eligible for autologous transplantation.
  • History of relapse of lymphoma following initial treatment with an anthracycline-containing regimen or disease that is refractory or progresses during initial therapy with an anthracycline-containing regimen.
  • Immunophenotyping of the lymphoma at the time of diagnosis or relapse using flow cytometry or immunohistochemistry.
  • Presence of clinically- and/or radiologically-documented, measurable, and/or evaluable disease at the time of relapse.
  • Received 2 cycles of salvage chemotherapy.
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  • Complete response (i.e., normal physical examination, lymph nodes, lymph node masses, and bone marrow) or a partial response (i.e., decrease of ≧50% in the size of lymph nodes or lymph node masses or decrease in size of liver/spleen on physical exam) to at least one cycle of a salvage chemotherapy regimen.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2.
  • Absolute granulocytes count ≧1.0*10^9/l.
  • Platelet count ≧75*10^9/l.
  • Aspartate aminotransferase (AST) or alanine transaminase (ALT) ≦2.5 times the upper limit of normal (ULN) or ≦5 times the ULN if liver involvement with lymphoma.
  • Life expectancy of at least 3 months.
  • >4 weeks since last cycle of chemotherapy.
  • Patient has recovered from all acute toxic effects of prior chemotherapy.
  • Signed informed consent.

Who cannot join

  • A second active malignancy (other than basal cell carcinoma of the skin).
  • Uncontrolled central nervous system involvement by lymphoma.
  • Positive/history of retroviral infection (HIV, HTLV-1).
  • Active infection requiring antibiotics during planned lymphoma-related therapy.
  • Previous treatment with high-dose chemotherapy or cytokine mobilization and hematopoietic progenitor cell transplantation.
  • Continued evidence by morphology and flow cytometry of bone marrow involvement after at least one cycle of salvage chemotherapy.
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  • ≥3 cycles of salvage chemotherapy following documentation of lymphoma relapse or disease progression.
  • (In patients with CD20(+) lymphoma) History of severe hypersensitivity reactions to rituximab.
  • Positive pregnancy test in female patients.
  • Lactating female patients.
  • Previously received experimental therapy within 4 weeks of enrolling in this protocol or currently enrolled in another experimental protocol during G-CSF Mobilization Phase.
  • Creatinine >1.5 times the ULN.
  • Bilirubin >1.5 times the ULN.
  • Ejection fraction <45%.
  • Diffusion capacity of the lung for carbon monoxide (DLCO) <50%.
  • Patients of childbearing potential unwilling to implement adequate birth control.
  • A co-morbid condition that renders the patient at high risk from treatment complications.
  • Residual acute medical condition resulting from prior chemotherapy.
  • Documented history of ventricular arrhythmias during the last 3 years.
  • Fever (temperature >38 °C/100.4 °F).
  • Actual body weight exceeds 175% of ideal body weight.
  • Participants who have deterioration of their clinical status or laboratory parameters between the time of enrolment and transplant (such that they no longer meet entry criteria) may be removed from study at the discretion of the treating physician, principal investigator, or sponsor.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Winship Cancer Institute

    Atlanta, Georgia, 30322

Other trials in United States

About this study

Official title: A Pilot Cohort Study of AMD3100 in Combination With G-CSF and Rituximab Compared With AMD3100 in Combination With G-CSF Alone for Mobilization of BPCs in Patients With Relapsed or Refractory NHL or HD Prior to Autologous HPC Transplant

Participants with non-Hodgkin lymphoma (NHL) or Hodgkin disease (HD) will be assigned to one of 2 arms based on the immunophenotype of their lymphoma.

(A)Participants with CD20(-) lymphoma will undergo mobilization with granulocyte colony-stimulating factor (G-CSF) and plerixafor.

Read more

(B) Participants with CD20(+) lymphomas will undergo mobilization with rituximab, G-CSF, and plerixafor. They will receive a weekly dose of rituximab beginning 1 week prior to, and continuing until 2 weeks after, the first dose of G-CSF.

Participants in both groups will receive G-CSF twice daily for 4 days. In the evening on Day 4, a dose of plerixafor will be administered. Apheresis will be initiated the next morning. Participants will continue to receive G-CSF twice daily and to receive the evening dose of plerixafor followed by apheresis the next morning for up to a total of 4 aphereses or until ≥5*10^6 CD34+ cells/kg are collected.

Participants who are transplanted will be monitored for the time to polymorphonuclear leukocytes (PMN), platelets (PLT), and lymphocyte engraftment. Follow-up assessments will be done at 100 days, and 6 and 12 months post-transplantation.

Read the detailed description

This is a single-center, 2-arm, non-randomized, open-label study to evaluate the safety of plerixafor when used in combination with rituximab (Rituxan®) and granulocyte colony-stimulating factor (G-CSF) in patients with relapsed or refractory Hodgkin disease (HD) or non-Hodgkin lymphoma (NHL).

Participants will be assigned to one of 2 arms based on the immunophenotype of their lymphoma.

(A)Participants with CD20(-) lymphoma will undergo mobilization with G-CSF and plerixafor.

(B) Participants with CD20(+) lymphomas will undergo mobilization with rituximab, G-CSF, and plerixafor. They will receive a weekly dose of 375 mg/m2 rituximab by intravenous (iv) infusion beginning 1 week prior to, and continuing until 2 weeks after, the first dose of G-CSF.

Participants in both groups will receive 7.5 µg/kg G-CSF twice daily (morning and evening) for 4 days. In the evening (approximately 10:00 pm) on Day 4, a dose of plerixafor (240 µg/kg) will be administered. Apheresis will be initiated the next morning, approximately 10 to 11 hours after plerixafor is given. Participants will continue to receive G-CSF twice daily and to receive the evening dose of plerixafor followed by apheresis the next morning for up to a total of 4 aphereses or until ≥5*10^6 CD34+ cells/kg are collected.

Participants with an adequate number of autologous peripheral blood stem cells (PBSCs) collected by apheresis will be admitted to the study center for the administration of high-dose chemotherapy and autologous transplantation. After transplantation, the times to PMN, PLT, and lymphocyte engraftment will be measured. Participants will remain hospitalized until they achieve an absolute granulocyte count of >500/µl in the peripheral blood. Graft durability will be assessed at 100 days, and 6 and 12 months post-transplantation.

This study was previously posted by AnorMED, Inc. In November 2006, AnorMED, Inc. was acquired by Genzyme Corporation. Genzyme Corporation is the sponsor of the trial.

Being tested
G-CSF plus plerixafor, rituximab
Keywords
AMD3100, stem cell mobilization, autologous transplant, Non-Hodgkin Lymphoma, Hodgkin Disease
Medical subject headings
Lymphoma, Non-Hodgkin, Hodgkin Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • G-CSF plus plerixaforDrug

    Also called AMD3100, Mozobil

    Participants underwent mobilization with G-CSF (7.5 µg/kg twice daily) for 4 days, administered by subcutaneous (sc) injection. On the evening of Day 4, participants received a dose of plerixafor (240 µg/kg), administered by SC injection. On Day 5, participants returned to the clinic and received a morning dose of G-CSF (7.5 µg/kg) and underwent apheresis approximately 10 to 11 hours after the dose of plerixafor. Participants were to continue to receive G-CSF twice daily and to receive the evening dose of plerixafor followed by apheresis the following morning for a maximum of 4 aphereses or until ≥ 5*10^6 CD34+ cells/kg were collected.

  • G-CSF plus plerixaforDrug

    Also called Mozobil, AMD3100

    Participants underwent mobilization with G-CSF (7.5 µg/kg twice daily) for 4 days, administered by subcutaneous (SC) injection. On the evening of Day 4, participants received a dose of plerixafor (240 µg/kg), administered by SC injection. On Day 5, participants returned to the clinic and received a morning dose of G-CSF (7.5 µg/kg) and underwent apheresis approximately 10 to 11 hours after the dose of plerixafor. Participants were to continue to receive G-CSF twice daily and to receive the evening dose of plerixafor followed by apheresis the following morning for a maximum of 4 aphereses or until ≥5*10^6 CD34+ cells/kg were collected.

  • rituximabBiological

    Also called Rituxan, MabThera

    Participants were given a weekly dose of rituximab 375mg/m2 by intravenous infusion for 1 week prior to and continuing until 2 weeks after the first dose of G-CSF.

Study groups in NCT00444912
Study groupRoleWhat they receive
G-CSF plus plerixaforExperimentalParticipants with CD20- lymphoma
Receives: Drug: G-CSF plus plerixafor
G-CSF plus plerixafor and rituximabExperimentalParticipants with CD20+ lymphoma
Receives: Drug: G-CSF plus plerixafor; Biological: rituximab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Summary of Adverse Events (AEs)

    Number of participants with adverse events (AEs) collected from Day 1 (start of G-CSF mobilization in participants with CD20- lymphoma or start of rituximab in participants with CD20+ lymphoma) to the day before starting chemotherapy. AEs were graded by the investigator using the World Health Organization (WHO) Adverse Event Grading Scale and were assessed for seriousness and relatedness to study treatment.

    Measured: Day 1 and up to Day 59 (maximum time before start of chemotherapy)

Secondary outcomes (11)
  1. Median Cumulative Number of CD34+ Cells Collected During Apheresis

    Median total number of CD34+ cells collected during apheresis.

    Measured: Days 5-8

  2. Median Fold Increase in the Number of CD34+ Cells After Plerixafor Administration

    Fold Increase = (Pre-Apheresis CD34+ cells/Pre-Plerixafor CD34+ cells).

    Measured: Days 4-5

  3. Median Number of Apheresis Days Required to Reach a Minimum of 3*10^6 CD34+ Cells/kg

    Median number of apheresis days in each treatment arm to collect a minimum of 3*10^6 CD34+ cells/kg.

    Measured: Days 5-8

  4. Median Number of Apheresis Days Required to Reach the Target of 5*10^6 CD34+ Cells/kg

    Median number of apheresis days in each treatment arm to reach the target of 5*10^6 CD34+ cells/kg.

    Measured: Days 5-8

  5. Median Number of Days to Polymorphonuclear Leukocyte (PMN) Engraftment

    Median number of days from transplantation to PMN engraftment which was defined as PMN counts ≥0.5*10^9/L for 3 consecutive days or ≥1.0*10^9/L for 1 day. Time to engraftment corresponded to the first day that the criteria were met.

    Measured: Days post transplantation (approximately Day 40)

  6. Median Number of Days to Platelet (PLT) Engraftment

    Median number of days from transplantation to PLT engraftment which was defined as platelet counts ≥20*10^9/L without transfusion for the preceding 7 days or platelet counts ≥50*10^9/L for one day. Time to engraftment corresponded to the first day that the criteria were met.

    Measured: Days post transplantation (approximately Day 40)

  7. Median Number of Days to Lymphocyte Engraftment

    Median number of days from transplantation to lymphocyte engraftment which was defined as lymphocyte counts ≥5*10^8/L. Time to engraftment corresponded to the first day that criteria were met.

    Measured: Days post transplantation (approximately Day 40)

  8. Median Level of CD19+CD2-CD14- B-cells Six Months Post-Transplant

    Measured: Approximately 7 months (6 months post-transplant)

  9. Median Level of CD19+CD2-CD14- B-cells Twelve Months Post-Transplant

    Measured: 13 months (12 months post-transplant)

  10. The Percentage of CD19+CD3-CD14- B-cells of the Total Cells on the First Apheresis Day

    Measured: Day 5

  11. Number of Participants With Durable Engraftment 12 Months After Transplantation

    The number of participants maintaining a durable graft 12 months after autologous transplantation. A durable graft is defined as the maintenance of normal blood counts.

    Measured: Approximately 13 months (12 months post-transplant )

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Mar 2007 (estimated)
  2. Study startFeb 2006
  3. Primary completionJun 2009
  4. Study completionJun 2009

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00444912
Sponsor's protocol ID
AMD31002113
Status last verified
Feb 2014
First submitted
7 Mar 2007
Last updated
13 Mar 2014
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing G-CSF plus plerixafor and rituximab in people with Non-Hodgkin Lymphoma and Hodgkin Disease, run by Genzyme, a Sanofi Company at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 22 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 Mar 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 29 Jul 2010). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Summary of Adverse Events (AEs) (time frame: Day 1 and up to Day 59 (maximum time before start of chemotherapy)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Mar 2014.

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